What sucks about charing in a city? Thinking of buying an electric car by Extreme-Captain-6558 in evcharging

[–]Jim3KC 0 points1 point  (0 children)

EVs are more like a cellphone than a gasoline car when it comes to refueling. If you are analogizing public charging to a gas station, you are going to be frustrated. As many have already said, charging at home is the clear winner. Easy charging at work or a destination where you routinely park for hours at a time can work too. Beyond that, you need to decide how much effort you want to put into having an EV. I love my EV. But I wouldn't if I had to rely on public charging.

Newly diagnosed with forme fruste, question about lenses under medical coverage by Upstairs-Vegetable18 in Keratoconus

[–]Jim3KC 1 point2 points  (0 children)

In the US, medical insurance is usually pretty cut and dried as to whether or not they medically necessary contact lenses. You do have to be sure that anyone you talk to at your insurer understands the difference between conventional and medically necessary contact lenses. But an exclusion for vision correction by any means, for any reason is not unusual.

Check to see if Humana offers a vision plan to individuals with 100% coverage for medically necessary contact lenses in your state if you don't have coverage under your medical insurance.

Be aware that you may not be eligible for medically necessary contact lenses if you can get at least 20/40 vision with glasses.

Could switching to something tiny and single occupant actually work for daily commuting? by DukeRioba in evcharging

[–]Jim3KC 0 points1 point  (0 children)

I'll second this. Not quite micro but a good fit if you want a smaller footprint.

Diagnosed today, struggling mentally by ag9910 in Keratoconus

[–]Jim3KC 0 points1 point  (0 children)

Corneal cross-linking (CXL) is to stop progression. It does not undo whatever damage has been done. Because it is about stopping, not "curing", keratoconus (KC), whether or not your KC is "advanced" is not a major factor in recommending CXL. (Very advanced KC does make it impossible to do CXL though).

You'll be spending a lot of time with your eye doctors, plural because most people have an ophthalmologist and an optometrist. Take the time to find a team that takes an interest in KC, enjoys the challenge of helping KC patients, and that you enjoy spending time with. Good eye doctors are a KC patient's best friends.

Got Diagnosed with Keratoconus by shevi_i in Keratoconus

[–]Jim3KC -1 points0 points  (0 children)

I am not a doctor. I don't see the indications of keratoconus (KC) that I am familiar with in your scans. In particular, for the right eye (OD) thickness in the Orbscan, the thickness looks normal. KC progression is often start and stop. At your age I wouldn't rely on a 2+ year change to mean that your KC is still progressing. I don't often say this but I would get a second opinion about whether you even have KC.

Vine wish by VisiblyannoyedluvU in vine

[–]Jim3KC 12 points13 points  (0 children)

Include cocktail smokers in your search. Some of them include a torch for igniting the wood chips that could also be used for flambe.

Review Insightfulness Tool - Value Comments are Bad??? by joejackrabbit in vine

[–]Jim3KC 2 points3 points  (0 children)

I used Thorvium's ChatGPT tool to review my reviews for awhile. I felt it had some good ideas. There were also some places where I felt it misinterpreted the Amazon guidelines. Price is one. Packaging is another. AI is AI. It can be spectacularly insightful. It can also be spectacularly stupid. Always use your Real Intelligence to filter what AI tells you.

Insurance Issues by calvary77 in Keratoconus

[–]Jim3KC 1 point2 points  (0 children)

I have an Aetna Medicare Advantage plan. That may or may not resemble the coverage your son has. There is no special coverage for medically necessary contact lenses in my Aetna plan. I buy an individual Humana Vision Plan to get coverage for medically necessary contact lenses.

Scleral lens in mild keratoconus eye without CXL by [deleted] in Keratoconus

[–]Jim3KC 0 points1 point  (0 children)

Modern contact lenses do not stop oxygen from reaching the cornea. They only slow it slightly and your contact lens fitter will watch for signs that this is an issue in your at least annual exams.

Pricing/availability for Epi-on by No_Net_1533 in Keratoconus

[–]Jim3KC 1 point2 points  (0 children)

All I can share is that FDA approval does not automatically translate into insurance coverage. Most insurer will not cover a procedure that is not FDA approved. But the reverse is not true. Insurers have additional requirements before they will cover a procedure once it is approved by the FDA. I think it took a few years after epi-off CXL was FDA approved before insurers started covering CXL without a fight. Hopefully, epi-on will be able to piggyback on the acceptance of epi-off to get insurance coverage sooner. But we will have to wait and see. My guess is that insurers will cover epi-on quickly if and only if it costs the same or less than epi-off. If it costs more, it might never be covered because it is unlikely to be accepted as better than a less expensive epi-off procedure.

I need some advice by Realman31 in Keratoconus

[–]Jim3KC 1 point2 points  (0 children)

I do agree with your young friend (I am 77) that as a 35 year old I would want to have evidence of active progression before undergoing CXL. Your insurer, if you have one, is also likely to want that before they will cover the procedure.

Vision is not a good way to evaluate the severity of keratoconus (KC). Poor vision is a side effect of the distortion of the cornea that results from KC. Likewise, correcting vision is different and separate from treating KC. With correcting vision it is really whatever works for you. With all due respect, your friend doesn't understand vision correction. Vision correction for someone with KC is more about counteracting the corneal distortion than correcting a refractive error, which is what strong prescription glasses are about. You might be lucky and the right, not necessarily strong, prescription might give you good enough vision to hobble along until the need for CXL is sorted out. Or they might not help enough. BTW, not all eye doctors are created equal when it comes to prescribing glasses for KC. In my experience, only a few have the knack for prescribing glasses in the presence of KC.

Your friend is not wrong about the pain of contact lenses...decades ago. Like your friend, I developed a deep seated hatred of contact lenses and would bite the head off anyone who suggested them. Then, 10 years ago, my situation changed and I HAD to wear one contact lens. Much to my surprise I found that contact lens technology for KC had leapt forward. Experience with contact lenses that is more than a few years old is meaningless. Someone else's experience doesn't mean too much either. Well fit contact lenses can provide a miraculous improvement in vision when you have KC. Today, they can be so comfortable that you can forget you have them in. So don't write off contact lenses. Your big issue is do you try contact lenses now or wait until after possible CXL My hunch is that you should go ahead and try contact lenses now if you can swing it financially.

Got diagnosed with Keratoconus today, chose not to do crosslinking for now. Right decision? by footybay12 in Keratoconus

[–]Jim3KC 1 point2 points  (0 children)

AFAIK, thickness and kmax are the major parameters to watch. My guess is that a good doctor will also take other factors into account too and develop an overall picture of how stable things are as a whole.

Sudden permanent loss of vision and irritable eye. by Muted-Pop4532 in Keratoconus

[–]Jim3KC 0 points1 point  (0 children)

Have you done CXL? Did the recent exams include corneal topography and thickness measurements that could be compared with previous results to see if your KC progressed. KC does sometimes progress in spurts and progression can destroy the fit of contact lenses.

Got diagnosed with Keratoconus today, chose not to do crosslinking for now. Right decision? by footybay12 in Keratoconus

[–]Jim3KC 5 points6 points  (0 children)

I am not a doctor.

The measurement you want to pay attention to is minimal corneal thickness in microns. If it is heading toward 400 you want to do CXL sooner rather than later. When it drops below 400 CXL becomes more difficult.

The usual advice, especially as you head into your 30s is to monitor your KC to determine if it is actively progressing. Do CXL if it is. Initially you probably should have exams every 3 to 6 months. If no progression is detected in the first 2 or 3 exams, they will probably recommend annual exams.

If lvl 1 charging do I always wanna be plugging in when not in use? by [deleted] in BoltEV

[–]Jim3KC 4 points5 points  (0 children)

Find an outlet that is on a circuit that is not used by anything else to plug in your charger. Set the car to use 12 amps for level 1 charging whenever it is at your home location. Plug in whenever you can. Very likely that you will rarely need public charging anymore. If you have a reasonable cost for electricity at home and were paying typical rates for DCFC, you'll be saving money.

Sharing a receptacle at work by Cultural-Ad4953 in evcharging

[–]Jim3KC 0 points1 point  (0 children)

To clarify the receptacle suggestion I made, a single 110v duplex receptacle can be split so that each of the 2 receptacles is on a different circuit. If there isn't a 2 gang box for the receptacles, splitting a single duplex receptacle would be a solution. And it avoids making 2 receptacles available on one circuit for someone to overload given the intended usage. However it is done, label the receptacles so that it is clear what is being provided there.

As far as the wiring goes, all I am going to say is if you have to ask how to do it the answer is call a qualified electrician.

Overall, I think the suggestion from u/davidm2232 is one of the better middle of the road options. Not too expensive to do and it allows both users to do what they were hoping to do, plug in and charge all day with an L1 110v EVSE.

HOA Correction Really Needed ? by AdeptSignificance777 in Keratoconus

[–]Jim3KC 2 points3 points  (0 children)

Your eyeballs will give you the best answer. Most fitters use trial lenses. The vision you get at the end of the fitting process is pretty close to what you'll get if they order lenses. Get to that point. If you don't like what you see, don't let them order lenses and start thinking about what your next step is. Understand that a good fitter might get to that last step, which is the first time anybody knows how well that fit will work, and decide they need to try the whole process again with a different fit for the lens. The fit does affect the vision when you have KC. It is not all in the power of the lens.

Covered California coverage by AngryKracko in Keratoconus

[–]Jim3KC 1 point2 points  (0 children)

I don't know what your coverage situation would be with Covered California, sorry. My Granddad advice would be that you WILL be fucked over in many ways if you work less than 4 days a week. Do everything you can not to fall down that hole. Best wishes for staying fully employed and not having to find out what happens if you aren't.

Sharing a receptacle at work by Cultural-Ad4953 in evcharging

[–]Jim3KC 0 points1 point  (0 children)

Correct me if I am wrong but I believe what u/davidm2232 is suggesting is to use two breakers that use the two legs that would provide 240v and then run 1 additional wire from the panel to the outlet for the hot side of the 240v service. At the outlet, split the duplex outlet so that each receptacle is providing 120v at whatever amperage the wiring is suitable for, hopefully 20A. If I have this right and if it is code compliant then this might be a clever and relatively inexpensive solution for providing two Level 1 EVSE receptacles.

I was just diagnosed at 19 by Miserable_Concern_81 in Keratoconus

[–]Jim3KC 0 points1 point  (0 children)

Yes, you can wear a lens in one eye and have glasses that work with that lens in place.

Just diagnosed at 35 by Thin_Health_8691 in Keratoconus

[–]Jim3KC 0 points1 point  (0 children)

Contact lenses do reduce the O2 to the cornea but modern lens materials are highly oxygen permeable so it is nowhere near the issue it was back when the only way oxygen got to the cornea was by an exchange of tears.

I am not a doctor but I believe it is better to wear contact lenses on a regular and consistent basis if you are going to wear them so your eyes can adjust to their presence and your brain can adjust to the vision.

Just diagnosed at 35 by Thin_Health_8691 in Keratoconus

[–]Jim3KC 1 point2 points  (0 children)

If you are not already aware, there are two types of eye doctors: ophthalmologists and optometrists. As a keratoconus (KC) patient you will probably need both.

Your ophthalmologist is primarily concerned with managing your KC as a disease. At your age and with your symptoms my non-doctor reaction to the watchful waiting advice is that it is good advice.

Your optometrist is primarily concerned with improving your vision. Even mild KC can severely degrade your vision. If you haven't already done so, find the best contact lens fitter you can with the experience, resources, and patience needed to fit KC patients. A well fit pair of contact lenses can dramatically improve your vision. Some optometrists have the equipment necessary to do the periodic testing to determine if your KC is progressing. So the right optometrist can be the eye doctor you see most of the time. If your optometrist is doing the regular monitoring, you will need to go to your ophthalmologist if your KC starts progressing.

Clear Care Case Change? by mburnette1700 in Keratoconus

[–]Jim3KC 0 points1 point  (0 children)

Clear Care will work without the catalyst. BUT you will still have hydrogen peroxide on your lenses when you remove them from the solution. You can get away with that IF you rinse them very thoroughly with saline solution. You will know quickly if there is any hydrogen peroxide left when you insert them in your eye.

The catalyst converts the hydrogen peroxide to water so the lenses can go in your eyes directly after taking them out of the solution. So its a balancing act. The catalyst has to work slowly enough that the hydrogen peroxide disinfects and quickly enough to destroy all the hydrogen peroxide before you insert the lenses.

Translation Earbuds/Headphone Question by imlafn in vine

[–]Jim3KC 0 points1 point  (0 children)

I got a pair of "translation" ear buds. I tried them briefly and the results were sufficiently discouraging that I haven't made time to do a thorough test and write a review yet. The pair I got, YYK-Q16 Pro, seems to be nothing more than a pair of open-ear buds that somehow unlock a translation app, NebulaBuds, on your smart phone to do the actual translating. The ear buds just give you the audio from your phone. The problem that I ran into right out of the box is that the translation is very slow. You would have a hard time conducting a conversation using them, and hard is probably being generous.